The objective of this project is to determine the efficacy of Adriamycin versus cyclophosphamide as single agents in the treatment of metastatic bladder cancer. Patients are randomized into measurable and non-measurable groups and receive either Adriamycin, 60 mg/Sq M, every three weeks for three doses, or cyclophosphamide, 1.2 g/Sq M, every three weeks for three doses. Clinical responses and in vivo and in vitro correlates of immune responses are measured. The data from this institution will be pooled with that from other participating institutions of the Chemotherapy Confederation of the National Bladder Cancer Project. Thus far, thirty patients with metastatic bladder cancer have been evaluated, eighteen of whom have been randomized. Ten were randomized to receive cyclophosphamide and eight to recevie Adriamycin. Five of the ten cyclophosphamide patients are currently evaluable, two of whom are classified as having a partial response, and the remainder as having no response. All eight Adriamycin patients are currently evaluable. One patient had a partial response and two have had stabilization of growth of measurable metastases. The remainder showed no response. CEA levels were normal in 9 patients and elevated in 11 patients with a wide range. Levels increased as disease progressed but varied greatly. Skin test response to DNCB was depressed in most patients and, whatever the original level, it did not change during disease progression. Chemotherapy seemed to have no influence on CNCB response, but variably depressed in vitro assays of cellular and humoral immunity. As soon as sufficient data regarding Adriamycin is accumulated, it will be replaced by another agent.